ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1920

Predictors of Doubling of Serum Creatinine at the Time of Biopsy in a Lupus Nephritis Cohort

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Vondenberg, Jaime (James) A., University of New Mexico, Albuquerque, New Mexico, United States
  • Shaffi, Saeed Kamran, University of New Mexico, Albuquerque, New Mexico, United States
Background

Lupus nephritis is associated with significant morbidity and it is imperative to study the factors associated with renal survival. We study the determinants of doubling of serum creatinine in a predominantly Hispanic cohort.

Methods

We identified patients with biopsy-proven lupus nephritis from the biopsy registry that comprises of biopsies performed between 2002-2016. Demographic, clinical, and biochemical variables were obtained from the registry and electronic medical records. We studied the factors associated with the doubling of creatinine by performing univariate Cox proportional hazard analysis. All significant associations (p <0.05) were studied in a multivariate Cox regression model. Patients were censored upon death or the last follow-up.

Results

Out of 62 patients with biopsy-proven lupus nephritis, 53 (85.5%) were female. Whites, Hispanics, and Native Americans comprised 35.5, 30.6, and 16.1% of the cohort, respectively while 56% of the participants identified ethnically as Hispanic. Mean biopsy age, serum creatinine, and spot urine Protein/Creatinine were 34.5 (SD 15.3) years, 1.34 (SD 0.83) mg/dl, and 4.2 (SD 4.9) g/g, respectively. Class IV (48.4%) and III (16.1%) were the most prevalent lupus classes. Median (IQR) follow-up was 474.5 (1170) days. On multivariate analysis, higher age at biopsy was associated with decreased risk of doubling of serum creatinine (Figure 1). A higher spot urine Protein/Creatinine and C4 level at the time of biopsy were associated with increased risk of doubling of serum Cr.

Conclusion

Previous studies have shown that biochemical markers at the time of kidney biopsy are a poor prognostic marker of renal outcomes in lupus nephritis. In this study, demographic, biochemical, and histological markers failed to predict doubling of serum creatinine. The age and the level of proteinuria at the time of kidney biopsy were associated with doubling of serum creatinine.